1
00:00:26,840 -->
00:00:33,340
Now let's cover the highly effect and very
important skill called conscious adult choking.
2
00:00:33,340 -->
00:00:38,120
Now in this scenario we have someone who is
eating at a table, they begin to choke, we
3
00:00:38,120 -->
00:00:42,090
know they were choking because they could
not cough, they could not breathe, they could
4
00:00:42,090 -->
00:00:47,030
not speak. This is a full obstruction if and
it need's help if it's gonna come out in most
5
00:00:47,030 -->
00:00:53,870
cases. If it's easy to activate the emergency
response team or call 911, great, but if not,
6
00:00:53,870 -->
00:00:59,420
we can wait until the patient goes unresponsive
before we actually take the time to call 911
7
00:00:59,420 -->
00:01:03,470
or activate a code. But in this case we're
gonna come up to the person, we're gonna look
8
00:01:03,470 -->
00:01:08,670
them in the eyes, "Are you choking"? They
nod "Yes". "I know how to help you. May I
9
00:01:08,670 -->
00:01:14,100
help you". They give me permission to help
them. They're still conscious and so we wanna
10
00:01:14,100 -->
00:01:18,990
get that permission from the patient if at
all possible. Now I'm gonna elevate their
11
00:01:18,990 -->
00:01:25,950
elbows, I'm gonna find the belly button. The
belly button is my landmark so that I can
12
00:01:25,950 -->
00:01:32,310
tuck my thumb in and put the fist just above
the belly button on their abdomen. I wanna
13
00:01:32,310 -->
00:01:38,170
stay below the xiphoid process which is approximately
right here, I wanna stay just above the belly
14
00:01:38,170 -->
00:01:43,840
button because this is where i find the diaphragmatic
region. This is exactly what I want so that
15
00:01:43,840 -->
00:01:50,039
I can bring that diaphragm up and in while
I compress the lower lobes of the lung, shoot
16
00:01:50,039 -->
00:01:55,080
the air up the trachea, popping that object
out, and it's effective the majority of the
17
00:01:55,080 -->
00:02:00,399
time. So I'm gonna take that hand, keep my
elbows out so I'm not on their ribs anymore
18
00:02:00,399 -->
00:02:05,149
than I have to be, and I'm gonna start with
my inward and upward thrust. And I'm gonna
19
00:02:05,149 -->
00:02:12,599
do these thrust, until either the object comes
out or the person goes unresponsive. In this
20
00:02:12,599 -->
00:02:19,000
case the object did come out. He began breathing,
coughing, clearing his own airways. I simply
21
00:02:19,000 -->
00:02:23,230
re-encourage him that he's doing fine. If
he feels like sitting down you can have him
22
00:02:23,230 -->
00:02:28,910
sit down. And if we had not already called
911, now would be the time to call 911 or
23
00:02:28,910 -->
00:02:35,780
call a code "if" they go unresponsive. If
we've already called 911 keep 'em coming,
24
00:02:35,780 -->
00:02:39,390
it's fine. Even though the object already
came out, it's always a good idea to have
25
00:02:39,390 -->
00:02:44,829
EMS stay on the way, so that if this person
opts not to go in, they can be checked out
26
00:02:44,829 -->
00:02:49,140
by the EMS professionals. They're gonna check
airway, they're gonna check some lung sounds
27
00:02:49,140 -->
00:02:52,920
to make sure there's no partial obstruction,
and they're probably do a quick assessment
28
00:02:52,920 -->
00:02:58,250
to make sure there is no internal bleeding
from the abdominal thrust. So if the individual
29
00:02:58,250 -->
00:03:04,930
does not opt to have that done to him, or
the EMS providers do not come, I always like
30
00:03:04,930 -->
00:03:09,400
to encourage them to go to their own practitioner
and just be looked over and made sure that
31
00:03:09,400 -->
00:03:15,430
everything is okay. Keep in mind, that if
this person were not to have this successful
32
00:03:15,430 -->
00:03:20,569
removal of the obstruction, they would probably
go unresponsive in a short amount of time.
33
00:03:20,569 -->
00:03:25,129
And it's then that we would assist them to
the ground carefully and begin the skill of
34
00:03:25,129 -->
00:03:31,780
unconscious adult choking. Now we're gonna
talk about special considerations as it relates
35
00:03:31,780 -->
00:03:37,180
to a pregnant woman. You know when we're doing
this lifesaving skill of trying to remove
36
00:03:37,180 -->
00:03:41,870
the obstruction from the airway, and the person
is pregnant, we need to understand that we're
37
00:03:41,870 -->
00:03:47,099
dealing with two patients, save mom, save
baby. So it's important that we're aggressive
38
00:03:47,099 -->
00:03:51,030
in our treatment, but there's a special way
to do it so that we don't injure the baby
39
00:03:51,030 -->
00:03:57,650
in the process. Let's take a look at how we
do that right now. When we have the, the person
40
00:03:57,650 -->
00:04:02,959
in front of us, we know the baby is here in
the normal location where we would do abdominal
41
00:04:02,959 -->
00:04:09,299
thrust. So we're gonna avoid the area altogether
by forming the fist and going under the breast
42
00:04:09,299 -->
00:04:13,810
with that fist on the sternum. We're then
gonna take that opposite hand, go under the
43
00:04:13,810 -->
00:04:20,519
breast and onto that fist that's on the sternum.
We're now gonna do inward thrusts, inward
44
00:04:20,519 -->
00:04:25,410
deep thrusts. And we're gonna continue to
do those compressions until the object comes
45
00:04:25,410 -->
00:04:30,880
out and the person begins to breathe normally
again. If they doesn't come out, they're gonna
46
00:04:30,880 -->
00:04:35,880
go unconscious. When they go unconscious,
we're gonna activate 911, and then we're gonna
47
00:04:35,880 -->
00:04:41,910
start doing our unconscious choking victim
compressions as we learned in the other segment.